Provider Demographics
NPI:1437418761
Name:MARQUES, ANA PAULA
Entity Type:Individual
Prefix:
First Name:ANA
Middle Name:PAULA
Last Name:MARQUES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 61732
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92602-6057
Mailing Address - Country:US
Mailing Address - Phone:949-929-1749
Mailing Address - Fax:
Practice Address - Street 1:26431 CROWN VALLEY PKWY
Practice Address - Street 2:STE 260
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92691-6360
Practice Address - Country:US
Practice Address - Phone:949-929-1749
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-07
Last Update Date:2014-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA36933106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist